Local

A vaccination vacation Doctors struggle to treat children who don't get immunized BY RICK HARRISON REPUBLICAN-AMERICAN

Needle stabs in both legs released streams of tears down Logan Arcuri's ruddy 13-month-old scream-stretched cheeks.

His father, Southbury resident Jason Arcuri, did not flinch in the Waterbury doctor's office Friday as Logan received a fourth and final dose of the vaccine to prevent pneumococcal disease.

"I'm considered the heartless one," Arcuri said of a blood-and-tears-friendly stoicism not shared by his wife. "You've got to learn pain sometime."

But parents have grown more resistant to legal requirements and medical advice to vaccinate their children. This resistance leaves pediatricians to struggle with the possible pain of excluding unvaccinated children from their practices or exposing infants to diseases before they are old enough to receive protection.

"Part of the issue now is that nobody remembers any of these diseases," said Dr. Sandra Carbonari, Logan's doctor and president of the Connecticut Chapter of the American Academy of Pediatrics. "They don't remember when you locked your kids in the house all summer because you were so afraid they would contract polio."

Recent outbreaks of measles — 21 cases in New York and two in Fairfield County — underline challenges physicians face to maintain immunity amid a skeptical public armed with more information — and misinformation — than ever.

"It's very difficult to counter non-scientific arguments with scientific arguments," Carbonari said. "It's like trying to have a rational discussion about something when the other side has irrational beliefs. You're talking two different languages."

Last year, 1.4 percent of Connecticut's 41,604 kindergarten students received a religious exemption from state regulations requiring vaccinations against measles, mumps, rubella, poliomyelitis, diptheria, tetanus, pertussis, haemophilus influenza type B, hepatitis B and chickenpox. Six years earlier, only .5 percent received such an exemption.

The state also allows a medical exemption. But there is no way to determine if a family holds genuine religious beliefs or simply disagrees with the science endorsing vaccines.

THE RISKS OF AVOIDING vaccinations can be steep.

Complications from measles occur in about 30 percent of cases and include diarrhea, ear infections, pneumonia and acute encephalitis possibly leading to brain damage. In less than .2 percent of cases, complications can lead to death.

Before the introduction of the measles vaccine in 1963, Americans contracted as many as 4 million cases a year. That number dropped to 1,497 by 1983 before an epidemic between 1989 and 1991 involved 55,622 cases that led to 123 deaths. Experts blamed low vaccination rates among preschool-age children.

Measles cases in Connecticut remain low, with only seven confirmed since 2000. But over the last 45 years, cases of pertussis, or whooping cough, have grown from a low of two in 1981 to 183 in 2012, up from 68 the year before.

Vaccine resistors leave doctors with a difficult choice. According to a 2011 study, 30 percent of Connecticut pediatricians surveyed have dismissed families from their practices because they refused to immunize their children.

The measles vaccine, usually administered with vaccines for mumps and rubella and called MMR, can cause mild problems such as fever, rash and swelling and more severe problems such as seizures, stiffness and — in less than one in 1 million doses — a serious allergic reaction.

Effects such as deafness and permanent brain damage after receiving the MMR vaccine have been reported but not proven. Medical experts have debunked reported links to autism as fraudulent or unsupported.

Litchfield pediatrician Dr. Lucia Benzoni doesn't exclude people from her practice for refusing vaccines. She prefers to reason with hesitant parents and try to convince them to at least approve the most relevant vaccines, like a tetanus shot for often-barefoot children. Or she'll describe a scenario in which someone carrying rubella 24 hours before showing symptoms could infect the mother of an eight-weeks-pregnant woman, causing that child to be born without a brain.

"It's not meant to be a scare tactic — it's reality," Benzoni said. "I use what can really happen in the real world to make them see what they believe is flawed."

But Winsted pediatrician Dr. Mohammed Khera takes a more compromising approach. He said most of his patients come from doctors who dismissed them because of their vaccine beliefs. And if he cannot persuade them to change their minds, he accepts their right to decline treatment.

"Sometimes I feel like I don't have a really good logical reason for them," Khera said. "Like, why are you giving us a chickenpox vaccine if you already have a medication to treat it?"

Khera did not vaccinate his children against chickenpox and declines to vaccinate them against seasonal flu, fearing side effects of the vaccines. He argues that treatments for both are readily available while immunity from getting the actual disease might last longer than after receiving a weaker version of the disease in a vaccine.

"I am completely 100 percent in favor of vaccines, but on an individual basis there are good logical questions behind it," Khera said. "If I tell them it's good for the public and good for everybody else, that, they are not convinced with."

Waterbury pediatrician Dr. Charles Fischbein might agree to postpone certain vaccines to comfort a concerned parent. But he won't kick anyone out of the practice because he does not want to punish the child, and doesn't want to give up respectfully reasoning with reluctant parents.

"I think nobody is a lost cause," Fischbein said. "I've been amazed how many people come out of the woodwork looking for measles-mumps-rubella when the newspaper stories came out with the measles outbreak. All of a sudden they were demanding it."

" It's a witches brew I tell ya! Designed to make you a slave to a lifetime of immunity from potentially deadly diseases, thereby disabling you from infecting others like your enemies. 'Tis the devil's work, have bacteria and viruses no right to survival? How else can one eliminate inferior members of the population unable to survive infections, who are now passing their weakened immune systems on to future generations, other then by denying them vaccines? It's the killing of a species, the human race! Before vaccines and antibiotics, less than 30% of people infected by the black plague or small pox survived, which made them stronger against future infections. We are killing ourselves with vaccinations! We must stop them before they eliminate all of humanity!

If you have not gathered that this diatribe is a sarcastic, tho' not without substance, tongue-in-cheek harangue from one who has all their immunizations (including flu, shingles, DPT, pneumonia, hepatitis B, etc.) up to date, then you have neither intelligence (needed to appreciate sarcasm) or a sense of humor. "

" Looking at today's poll question addressing whether kids who are not vaccinated should be allowed in public schools, my first instinct was to say no, of course not!! They could bring back some deadly diseases. But then I thought, so what? It will likely only affect the kids whose parents didn't want them vaccinated, those who were would be immune. So where's the harm? Let those parents deal with the consequences of what will happen. Hopefully they'll be able to live with it. "

Why don't you people look at the inserts on those vaccines,and see what the score is.Ask to see them before they poke your kid like a pin cushion.I'm willing to bet they'll give you an excuse why you can't!You wonder why the rate of autism is on the rise? Then there's the pile of crap about how they,they being the shills,and prostitutes, for the big pharma,did a study that said these vaccines don't cause autism.Of course they don't! Especially when your paid off by big pharma,you'll say anything! You know all those child hood cancers that are on the rise? Guess what part of that is from? So go ahead keep vaccinating those kiddies!Wise up people,you're being sold a pile of Bull Crap,by these Medical Establishments,and the ones being victimized are the kids! "

" Yes there are PROVEN good vaccines I agree. I also agree with Genious 100%. Using our kids for unproven experiments just because Medical Establishments say it's a good idea is alarming. The body has to build immunity not be injected with viruses to make the body fight them. "

" Most outbreaks are in vaccinated children. Most adults are not vaccinated for the diseases children are vaccinated for these days--some four dozen before they enter school. Yet, they are somehow alive. Poor kids these days, plagued with asthma, allergies, cancers and more. They are very unhealthy, no thanks to vaccines.

Every vaccine has the potential to cause serious side effects, including death. Do your research parents. You do NOT have to vaccinate for school and daycare. Check the NVIC.org site for info on state laws.

After my child was vaccine-injured, I did not allow any more of my children to be vaccinated and as teenagers and young men, they are fine. It's a myth that vaccines make you healthy. "

" Sure, Linda. He was 15 months old and the picture of health. Never in daycare or with a babysitter, no other siblings at the time, no other sick people around and breastfed. Ten days after his MMR vaccine, he suddenly became seriously ill with pneumonia, and he then was plagued with repeated ear infections, respiratory infections, asthma and allergies where he had none before and by the time he was three he was a mess. It took years to regain his health with the help of a naturopath who helped build his immune system back up. We spent countless, sleepless nights and thousands of dollars on doctors, specialists and medications. He was lucky--no autism and at age 23, he is now fine. So are his unvaccinated brothers. "

Post a reader comment

We encourage your feedback and dialog. Please be civil and respectful.If you're witty, to the point and quotable, your reader comments may also be included on the Around the Towns page of The Sunday Republican. Readers must be registered and logged in to post comments on the site. Registration is free. Click Here to register.
A Subscription is not required to post comments only a Registration.